MÚSCULO ADUTOR DO POLEGAR: SUA ESPESSURA COMO PARÂMETRO ANTROPOMÉTRICO E PROGNÓSTICO EM PACIENTES CIRÚRGICOS

Abstract

Background & objectives - To measured the APMT in two groups (healthy adults subjects and surgical patients) and compare this values with the Subjective Global Assessment. Methods - Adductor pollicis muscle thickness (APMT) was obtained from a standardized method, using a Lange® skinfold caliper, in 300 healthy volunteers. These mean values and their standard deviation were used as reference values according to sex and age group and APMT values under the 5th percentile were considered as depletion of muscle mass (malnutrition). A sample of three hundred and sixty one surgical patients had their APMT measured and nutritional status assessed by Subjective Global Assessment (SGA). Paired t test was used to compare the APMT values found in patients to the expected limit of the sex and age reference values; analysis of variance (ANOVA) and Bonferroni tests evaluated the difference of patients APMT values according to the nutritional status groups (SGA A, B or C). It was tested the association between malnutrition assessed by SGA and from APTM (chi-squared test). A multivariate linear regression was performed to identify the most important significantly determinants of APMT in the group of patients. All the analyses were performed using (STATA 9.0®), for dominant and non-dominant sides. Results - The healthy volunteers were fifty healthy men and women, from each age group (18 to 30 years; 31 to 60 years and older than 60 years). Most of the patients were female (60.4%) and the mean age was 49.4 ± 17.8 years. The APMT values were significantly different among SGA groups. Bonferroni's test showed that nourished patients have APMT values significantly higher than moderately and 38 severally malnourished patients, but there is no significantly difference between APMT values found in moderately and severally malnourished patients, for both sides. Only nourished and suspect or moderately malnourished patients had APMT values significantly higher than the 5th percentile from reference values. It was found a significantly association between malnutrition (SGA B and C) and APMT below 5th percentile (RR = 3.99 and 3.92, for dominant and non-dominant side, respectively). The sex, age, current weight and nutritional status were considered significant determinant factor for APMT after a multivariate linear regression. Conclusion This study showed that APMT is significantly associated to nutritional status in a sample of surgical patients. New studies may show the usefulness of this new anthropometric parameter in nutritional assessment of muscle mass